Jessica Gold, MD, is a clinical assistant professor and pediatrician at Stanford. After her second child, Gold began looking into workplace challenges that mothers face in the medical field. In a recent paper in the Journal of Hospital Medicine, she identified a policy that made career advancement more difficult for hospital-based pediatricians who have taken maternity leave. Her work ultimately led to a change.
I spoke with Gold about her career in the budding field of pediatric hospital medicine and what she's learned about professional obstacles for women physicians.
Where were you before you came to Stanford?
I grew up in the Bay Area, but I did all my medical training in New York City. Before I came to Stanford I was on the faculty at Columbia as a pediatric hospitalist.
What got you interested in medicine, and in pediatrics specifically?
As far back as middle school, I was saying I wanted to be a doctor. When I was in medical school doing my rotation with pediatrics, and comparing that with internal medicine, I realized that I really loved taking care of children.
Then I did my residency in pediatrics when pediatric hospital medicine was just starting to emerge as a field. A pediatric hospitalist is a pediatrician who takes care of children who are admitted to the hospital. If a kid comes into the hospital with, for example, pneumonia and needs to be on antibiotics and in the hospital for several days, we'll help that child during their stay.
How did you become interested in the subject of gender bias in the medical profession?
I started taking an interest in this problem when I came back to work after my second maternity leave. I found it really difficult to manage everything at work and at home, and also be academically productive, all on no sleep.
I started to realize that it wasn't just me; a lot of factors contribute to this being a particularly challenging time for women. Some of the reading I did indicated that the majority of the wage gap between men and women is due to motherhood: the gap is actually small at first, but then widens significantly after motherhood. Even in pediatrics, where over 70% of the residents entering are women, the majority of departmental leadership is still male. So that was how I initially became interested in the topic in general.
What is the specific issue you address in your perspective piece?
The paper was about a problem that emerged within pediatric hospital medicine. Any time there's a new subspecialty, the American Board of Pediatrics has to ask: What will you do with all the people who were practicing in that specialty before it was officially recognized? If someone has worked in pediatric hospital medicine for six years, will they need to have additional training to be certified as a pediatric hospitalist? As a solution, the board came up with this process where, if you have a minimum of four years of uninterrupted practice in the field, you qualify to take the certification exam without doing additional training.
What started to emerge was that some women who disclosed maternity leave as an "interruption" in their practice on their application were subsequently denied the opportunity to take the exam. If you're denying women the opportunity to be certified in their specialty because of maternity leave, they may not be able to get a job in a competitive market or a leadership position in academia.
What action did you take?
At the Pediatric Hospital Medicine national meeting, I got together with a group of women who were also concerned about this problem, and we decided to work together to lobby the board. We conducted our own survey of the hospitalist community to characterize who was being denied certification, and we found that several women were denied on the basis of having taken maternity leave. At the same time, a separate group was also circulating a petition to the hospitalist community to get the criteria changed for board certification.
Next, we wrote a letter to the president of the American Board of Pediatrics asking the board to disregard the "interruption" criterion for maternity/medical leave. We explained how it leads to discrimination against women who have babies during residency, and women who have a child after residency and before certification.
The Board wrote back and said they'd decided to remove the practice-interruptions criterion. However, they claimed in their official response that their data showed no evidence of gender discrimination, so I don't think they're seeing the full impact. On the plus side, there seems to be an awareness that this period of time is really important for women.
Are you involved in any other efforts to champion women in the workplace?
I'm co-chairing the Stanford School of Medicine's Working Parents Employee Resource group, and I'm hoping to help make things better for other parents in similar situations.
Photo by Daphne Sashin